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Individual
MRS. FALLON FUNDERBURK
Active
Individual
MRS. FALLON FUNDERBURK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN, CNOR, RNFA
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN105855
LA
Other
Enumeration date
11/22/2014
Last updated
08/01/2017
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